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KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameKANSAS CROSSING CASINO HEALTH AND WELFARE PLAN
Plan identification number 501

KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

KANSAS CROSSING CASINO has sponsored the creation of one or more 401k plans.

Company Name:KANSAS CROSSING CASINO
Employer identification number (EIN):472347487
NAIC Classification:713200
NAIC Description: Gambling Industries

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-06-01GARY MATTSON2019-11-12
5012018-06-01GARY MATTSON2020-09-15
5012017-06-01

Plan Statistics for KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN

401k plan membership statisitcs for KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN

Measure Date Value
2018: KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01207
Total number of active participants reported on line 7a of the Form 55002018-06-01181
Number of retired or separated participants receiving benefits2018-06-011
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01182
Number of employers contributing to the scheme2018-06-010
2017: KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01100
Total number of active participants reported on line 7a of the Form 55002017-06-01157
Number of retired or separated participants receiving benefits2017-06-010
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01157
Number of employers contributing to the scheme2017-06-010

Form 5500 Responses for KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN

2018: KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: KANSAS CROSSING CASINO HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01First time form 5500 has been submittedYes
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number911442
Policy instance 1
Insurance contract or identification number911442
Number of Individuals Covered181
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $34,422
Total amount of fees paid to insurance companyUSD $741
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $741,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,422
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number911442
Policy instance 1
Insurance contract or identification number911442
Number of Individuals Covered207
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $37,583
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $866,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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